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Full healing of small interportal hip capsulotomy sites found with, without capsular repair
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Simultaneous bilateral hip arthroscopy with or without capsule repair demonstrated progression to contiguous healing on MRI at 24-week follow-up, according to results.
Among 15 patients with femoroacetabular impingement who underwent simultaneous bilateral hip arthroscopy using a small interportal capsulotomy, Omer Mei-Dan, MD, and colleagues randomly assigned the first hip to either capsular repair or no capsular repair, followed by the opposite treatment on the contralateral hip. Researchers performed MRI at 6 weeks and 24 weeks postoperatively, which were analyzed by two blinded musculoskeletal radiologists. To assess the rate and extent of capsular healing, researchers measured and analyzed capsular dimensions at the level of the healing capsulotomy site, as well as at locations both proximal and distal to the defect in hips with a persistent defect.
Results showed eight hips and three hips treated with and without capsular repair, respectively, had a continuous hip capsule with no apparent capsulotomy defect at 6 weeks postoperatively. Researchers found 17 of 19 hips with a discontinuous capsule at 6 weeks were available for follow-up at 24 weeks postoperatively. Of the 17 hips, all hips had progression to healing, with a contiguous appearance without defects, according to results, as well as no difference in capsular dimensions between treatment cohorts.
“Like with any other arthroscopic procedure, visualization during hip arthroscopy is key. Performing capsulotomy at the beginning of the case is mandatory, although many surgeons would do a large capsule cut, which is not always necessary to achieve surgical goals,” Mei-Dan told Healio.com/Orthopedics. “Our study shows that when we utilize small interportal hip capsulotomy, as opposed to large (greater than 35 mm) or “T” capsulotomy and in cases where there is no hip instability, the capsule cut can be left open and we can still expect full healing.” – by Casey Tingle
Disclosures: Mei-Dan reports he receives grants from ArthroCare and other support from Smith & Nephew. Please see the full study for a list of all other authors’ relevant financial disclosures.
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